Information for babies with left torticollis

General information
Torticollis means ‘twisted neck’ and is caused by a swelling (tumour) in one of the
muscles in the side of the neck. This is the sternomastoid muscle, which runs from
behind the ear to the point of the collarbone and breastbone.

Any unusual lump or swelling in the body may be called a tumour; this does not
mean that it is a growth like cancer.

An infant with torticollis lies with the head tilted to one side and rotated to the other.

In many cases, but not all, a nodule is evident in the belly of the muscle, becoming
obvious in the second or third week of birth. If this condition is not treated early and
consistently, the baby’s head will become moulded from lying in one position too
much, making the face look lopsided. Later, as the child grows it would develop a
curvature of the spine to compensate for the tilt of the head. It can take a year or
longer to fully resolve as the child’s motor development is maturing.

When discovered early, and exercises and positioning are followed consistently, the
majority recover completely with no long-term effects. In cases that do not respond to
exercises by age one, surgical release of the sternomastoid muscle may be required.

Source: Physiotherapy
Reference No: 5396-3
Issue date: 25/01/23
Review date: 25/01/26
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Exercises for LEFT torticollis
In a child with left torticollis, the head is tilted to the left and the face is rotated to the
right, therefore when stretching, you will need to tilt your child’s head to the right
(right ear to right shoulder) and turn their face to the left (look over left shoulder).

The following exercises are best done with your child placed on the floor on their
back. If you have help with the exercises, your assistant can stabilize the shoulders
while you do the stretching exercises.

Side bending
Hold your child’s LEFT shoulder down with your RIGHT
hand. Place your LEFT hand on top of the LEFT side of
your child’s head and slowly bend their head towards their
RIGHT shoulder.
Hold for a count of 5
Repeat x 3

Rotation
Place your LEFT forearm against your child’s RIGHT
shoulder, and cup your child’s head with the same hand. Use
your RIGHT hand to hold your child’s chin. Slowly rotate your
child’s face to their LEFT.
Alternatively, roll your child onto the LEFT side. Keep their
interest with a toy or eye contact. Gently roll your child's body
onto their back whilst keeping their head rotated to the LEFT.
Hold for a count of 5
Repeat x 3

Alternatively, roll your child onto the LEFT side. Keep their
interest with a toy or eye contact. Gently roll your child's
body onto their back whilst keeping their head rotated to
the LEFT.
Hold for a count of 5
Repeat x 3

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 When your baby is a little older, your physiotherapist may
show you this way of gently stretching the neck muscles.

Playing positions
Place the child on their tummy with a small rolled up towel under their chest. Place
toys so the child has to turn their face to the LEFT. For a further stretch in this
position, gently lift the child’s legs and hips off the floor. Build up the time he spends
on his tummy gradually.

Do NOT put your child on their tummy to sleep.

The position shown here is good for encouraging

midline positioning of the head as well as
interacting with your child.

Another useful play position is side lying which

also facilitates midline head position.

When playing on their back you may need to use a rolled towel to maintain midline
position of the head. Your physiotherapist will show you how to do this.

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 Carrying
Hold the child facing away from you, in a side lying
position, with the child’s LEFT ear resting against your
LEFT forearm. Place your RIGHT arm between the child’s
legs and support the child’s body.

Other advice
• Hold toys so that your child has to look up and out to the LEFT.
• Position your child in their cot so you approach them from the LEFT.
• When holding your child across your shoulder, position them to face the LEFT.
• When in their car seat, use a rolled up towel to correct their head position.
• Use a rolled towel for when the child is lying in their pram to correct the position of
the head. Your physiotherapist will show you how to do this.

Do NOT use the rolled towel when the child is sleeping or unsupervised.

• Encourage the child to lie on either side to gain the midline position of the head.
• When the child is breastfeeding on the RIGHT breast, gently position them so they
have a stretch taking the RIGHT ear to their RIGHT shoulder.
• If bottle feeding, hold your child in your RIGHT arm so that they have to turn to the
LEFT or midline to feed.

If you think that your baby is being caused discomfort by any of these
exercises, stop doing them and contact your physiotherapist.

General advice
• Work gently within your baby’s tolerance
• Slowly increase the motion over time
• Find the position and time of day that works best for your baby
• Hold these gentle stretches for as long as is tolerated
• Stop the stretch sooner if your baby starts to resist the motion or becomes fussy
• You should never feel like you are forcing the motion
• Use your voice or favourite toys to distract and soothe your baby

Contacts

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Remember your physiotherapist is always available for help and advice should you
have any further concerns or queries about your baby.
Please contact the therapies department on 01284 713300.

If you would like any information regarding access to the West Suffolk Hospital and its
facilities please visit the website for AccessAble (formerly DisabledGo)
https://www.accessable.co.uk/organisations/west-suffolk-nhs-foundation-trust

© West Suffolk NHS Foundation Trust

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